In the eighth episode of Sky Sport Doctor, which aired on Saturday, December 14, 2024, the Director of Isokinetic Torino, Dr. Fabrizio Tencone, continued the in-depth discussion on ankle sprains that began in the previous installment.
How long does it take to return to playing after an ankle sprain?
It’s not possible to give a precise answer. As I always tell my patients, the recovery time varies greatly depending on the severity of the injury.
For a simple sprain, you can return to playing after just a few days. A simple sprain is what is commonly referred to as a basic “twist”.
In more severe cases, it may take many months. A serious sprain can cause a bone fracture and, although rarely, surgery might even be required to reconstruct the damaged ligaments.
How do you recover from an ankle sprain?
Rehabilitation and recovery after an ankle injury is a progressive process, which we tend to structure by dividing it into phases.
Throughout this recovery process, the most important rule is to respect the progression of rehabilitation: taking it step by step, achieving one recovery goal at a time. For example, if you’re not yet walking properly, you certainly can’t start running, and so on.
In the first phase of rehabilitation, the ankle:
… must no longer hurt;
… must reduce swelling;
… must regain proper movement and articulation.
The first phase of treatment ends when you are able to walk perfectly well, and pool exercises are extremely important.
In water, the joint is protected, allowing for a quick progression from simple walking to increasingly intense sport-simulation exercises, even incorporating sport-specific objects like a ball.
And once you’re walking well, can you start running?
That’s exactly right. Once the first goal — walking well — has been achieved, the focus shifts to the next one: running and preparing for the return to the rehabilitation field.
In this phase, rehabilitation takes place in the rehab gym and is primarily focused on strengthening the muscles around the ankle.
In the second phase of rehabilitation, the ankle:
… must return to running on the treadmill;
… must have a strong ankle;
… and must begin to do the first small jumps without fear of landing on the injured ankle.
For this, we use cutting-edge techniques for visual analysis and studying foot placements to determine whether a landing from a jump is proper or improper.
This technology allows us to understand how much a person tends to protect the landing by still putting weight on the healthy leg and not trusting the injured one.
Only when the landings are symmetrical can we say that the fear of stepping and jumping has been overcome!
And at this point, are you good to go? You’re running well and jumping well: can you rejoin the team?
No, it’s not time for the team yet. Running fast or jumping well isn’t enough to be considered ready after a serious ankle injury.
It is necessary to complete rehabilitation with the “testing phase,” the so-called field rehabilitation, where movements and increasingly intense gameplay are practiced.
The final approval to return to play can be given only after thoroughly measuring all the important sports parameters: strength, movement quality, and physical fitness.
The athlete often says to me, “I feel good, let me go back to playing!” I reply, “I trust you, I can see you’re doing better, but I want to, or rather I must, measure how much better you really are”.
“If a strength or movement test requires you to score 10, you need to achieve 10, not almost 10. Only when all the tests are in order will we allow you to return to play! Because if things aren’t done properly, you risk getting injured again!”
Does all of this apply to the average athlete as well?
This program is even more important for the average athlete.
Professional athletes have entire medical and technical teams supporting them, yet we still see that sometimes even professionals don’t recover well after a serious injury.
But it’s the average athlete who must make an effort to do things properly, avoid rushing, and recover fully before returning to sports after an injury.
In particular, when it comes to ankle injuries, the most serious complication is that the ankle doesn’t heal properly, becoming unstable, leading to frequent sprains and difficulty returning to being the player you were before!
Therefore, let’s not underestimate the recovery after an ankle sprain, and from now on, let’s stop saying, “Oh, it was just a twist!”
